Official Statistics

Mortality profile commentary: February 2024

Published 6 February 2024

Applies to England

What’s new

Eighteen new indicators have been added in this update, providing trends in mortality rates for a greater range of leading causes of death in England. These are listed in the Appendix below, which also details updates for existing indicators.

Mortality rates are provided for single years from 2001 to 2022, or in 3-year moving averages from 2001 to 2003, to 2020 to 2022.     

Mortality rates from 2012 onwards were calculated with population estimates from the Office for National Statistics, which are rebased on results of the 2021 Census. Mortality rates now presented in the profile are not comparable with rates published in earlier versions.  

Introduction

The Mortality Profile brings together a selection of mortality indicators, including from other Office for Health Improvement and Disparities (OHID) data tools such as the Public Health Outcomes Framework, making it easier to assess outcomes across a range of causes of death.

The Alcohol Profile has also been updated and includes indicators for deaths related to alcohol. For a summary of the main findings please view the Alcohol Profiles for England: February 2024 update.

Mortality rates produced for the Mortality Profile are directly age-standardised rates, which adjust for differences in the age structure of the population between areas and population groups.

Indicators have been produced using 3-year and single year (where appropriate) time periods, for England, English regions, upper tier and lower tier local authorities, as well as deprivation deciles based on upper and lower tier local authorities.

Main findings

This update shows that:

• in England between 2001 and 2019, the rate of mortality from all causes and for all ages fell by 28% for males and by 23% for females
• the level of improvement in mortality rates slowed from around 2011. Between 2001 and 2010, the all-cause mortality rate fell by 21% for males and by 16% for females, but between 2010 and 2019, the rate fell by only 9% for males and by 8% for females
• between 2019 and 2020, the all-cause mortality rate in England increased by 15% for males and by 12% for females, due to the COVID-19 pandemic
• between 2021 and 2022 the mortality rate for both sexes reduced, but the 2022 rate for males was still 5% higher than the pre-pandemic rate for 2019, and the rate for females was still 4% higher
• between 2021 and 2022, there was a significant increase in the mortality rates for persons of all ages from circulatory disease, ischaemic heart disease, respiratory disease, influenza and pneumonia, chronic lower respiratory disease, chronic obstructive pulmonary disease, and dementia and Alzheimer’s
• between 2021 and 2022, there was a significant increase in the mortality rates for persons under 75 from circulatory disease, respiratory disease, chronic lower respiratory disease and respiratory diseases considered preventable
• though mortality rates for most causes (and for all causes) decreased in England between 2001 and 2019, the rate for liver disease increased over this period, by 31% for males and by 32% for females. Between 2019 and 2022, there was a further increase of 12% for males and 6% for females

Mortality rates for principal causes of death

In 2001, circulatory disease mortality rates were higher than cancer mortality rates: 45% higher for males and 46% higher for females (Figures 1 and 2). Over the next 10 years, for both sexes the mortality rate from circulatory disease fell faster than the rate for cancer, and since 2011 the rate for cancer has remained higher than the rate for circulatory disease. However, in 2022, the male rates for circulatory disease and cancer were very similar (298 per 100,000 population and 301 per 100,000 respectively).

Between 2001 and 2011, the circulatory disease mortality rate decreased by 40% for males and 39% for females. Between 2011 and 2019, a slightly shorter time period, the level of improvement slowed and the rate decreased by only 18% and 21% for males and females respectively. However, between 2019 and 2022, the circulatory disease mortality rate increased, by 6% in males and 3% in females.

The decrease for cancer mortality was more consistent across the whole of this period, the rate fell by 23% for males and 17% for females between 2001 and 2022. 

Figure 1: Male age-standardised mortality rates for principal causes of death, all ages, England, 2001 to 2022

Figure 2: Female age-standardised mortality rates for principal causes of death, all ages, England, 2001 to 2022

Between 2001 and 2022, for both sexes, there was a downward trend in deaths from respiratory disease and an upward trend in deaths from Alzheimer’s disease and dementia.

In 2022, mortality rates from COVID-19 were significantly lower than they had been in 2020 and 2021 for both sexes. Between 2021 and 2022 the rate fell by 66% for males and 68% for females.

Methodology

The Mortality Profile provides mortality rates for both selected chapters within the International Classification of Diseases, Tenth Revision (ICD-10) and specific causes within chapters. The choice is based primarily on leading causes of mortality with the highest numbers of deaths, and causes which are of particular public health interest.    

Deprivation deciles split by upper and lower tier local authorities are generated using the Index of Multiple Deprivation 2019 local authority scores. They are created by ranking upper and lower tier local authorities in England from most to least deprived and dividing these into 10 categories with approximately equal numbers of local authorities in each. 

Comparability ratios

The Office for National Statistics (ONS) uses software to automate the translation of cause of death information on death certificates from text to International Classification of Diseases (ICD) codes, and to select the underlying cause of death.

When software changes occur, which may be to include codes for new conditions and/or to incorporate changes to the rules used to select the underlying cause of death, ONS carry out a dual coding exercise. A sample of deaths are coded independently using the old and new software, to analyse the differences in coding brought about by these changes.

Comparability ratios are the number of deaths coded to an underlying cause in the new version, divided by the number of deaths coded to the same underlying cause in the old version.

To make counts of cause-specific deaths comparable over time, numbers for years between 2001 and 2021 were adjusted using comparability ratios, to take account of coding changes across this period.

These coding changes impact the selection of the underlying cause, but they do not affect indicators based on any mention of a disease on the death certificate. For those indicators, no adjustment to numbers was necessary.    

Revisions

Counts of deaths prior to 2022 have been revised (where appropriate) using comparability ratios, to enable data to be comparable to deaths in 2022.

Data included in this update use rebased population estimates from ONS from 2012 onwards.

For enquiries or feedback relating to the Mortality profile, email profilefeedback@dhsc.gov.uk.

Appendix

In this update, 18 new indicators have been added, with data added for 2001 to 2022:

• Mortality rate from leukaemia and lymphoma, all ages and under 75s
• Mortality rate from prostate cancer, all ages
• Mortality rate from oesophageal cancer, all ages
• Mortality rate from bladder cancer, all ages
• Mortality rate from stomach cancer, all ages
• Mortality rate from influenza and pneumonia, all ages
• Mortality rate from chronic lower respiratory disease, all ages and under 75s
• Mortality rate from cirrhosis and other diseases of liver, all ages and under 75s
• Mortality rate from accidents, all ages
• Mortality rate from accidental falls, all ages
• Mortality rate from infectious and parasitic diseases, all ages
• 4 of the 18 new indicators are based on any mention of a disease on the death certificate, rather than being based on the underlying cause of death:
• Mortality rate for deaths involving hypertensive disease, all ages
• Mortality rate for deaths involving diabetes, all ages
• Mortality rate for deaths involving dementia and Alzheimer’s, all ages
• Mortality rate for deaths involving influenza and pneumonia, all ages

The following existing indicators have been updated and now include data from 2001 to 2022:

• Mortality rate from all causes, all ages and under 75s
• Mortality rate from cancer, all ages and under 75s
• Mortality rate from lung cancer, all ages and under 75s
• Mortality rate from breast cancer, all ages and under 75s
• Mortality rate from colorectal cancer, all ages and under 75s
• Mortality rate from all circulatory diseases, all ages and under 75s
• Mortality rate from ischaemic heart disease, all ages and under 75s
• Mortality rate from stroke, all ages and under 75s
• Mortality rate from liver disease, all ages and under 75s
• Mortality rate from respiratory disease, all ages and under 75s
• Mortality rate from chronic obstructive pulmonary disease
• Mortality rate from dementia and Alzheimer’s disease, all ages
• Under 75 mortality rate from causes considered preventable
• Under 75 mortality rate from cardiovascular diseases considered preventable
• Under 75 mortality rate from cancer considered preventable
• Under 75 mortality rate from liver disease considered preventable
• Under 75 mortality rate from respiratory disease considered preventable
• Infant mortality rate
• Under 75 mortality rate from accidents

The following indicators have been updated to include data for 2020 to 2022:

• Mortality rate for deaths due to COVID-19, all ages and under 75s
• Mortality rate for deaths involving COVID-19, all ages and under 75s

The following indicators, drawn from other profiles, have been updated to the latest time period:

• Suicide rate
• Killed and seriously injured (KSI) casualties on England’s roads
• Fraction of mortality attributable to particulate air pollution